Clinical features and mortality in COVID-19 SARI versus non COVID-19 SARI cases from Western Rajasthan, India

Abstract

Background: In March 2020, the Indian Council of Medical Research (ICMR) issued guidelines that all patients presenting with severe acute respiratory infections (SARI) should be investigated for coronavirus disease 2019 (COVID-19). Following the same protocol, in our institute, all patients with SARI were transferred to the COVID-19 suspect intensive care unit (ICU) and investigated for COVID-19. Methods: This study was planned to examine the demographical, clinical features, and outcomes of the first 500 suspected patients of COVID-19 with SARI admitted in the COVID-19 suspect ICU at a tertiary care center. Between March 7 and July 20, 2020, 500 patients were admitted to the COVID-19 suspect ICU. We analyzed the demographical, clinical features, and outcomes between COVID-19 positive and negative SARI cases. The records of all the patients were reviewed until July 31, 2020. Results: Of the 500 suspected patients admitted to the hospital, 88 patients showed positive results for COVID-19 by reverse transcription-polymerase chain reaction (RT-PCR) of the nasopharyngeal swabs. The mean age in the positive group was higher (55.31 ± 16.16 years) than in the negative group (40.46 ± 17.49 years) ( P < 0.001). Forty-seven (53.4%) of these patients in the COVID-19 positive group and 217 (52.7%) from the negative group suffered from previously known comorbidities. The common symptoms included fever, cough, sore throat, and dyspnea. Eighty-five (20.6%) patients died in the COVID-19 negative group, and 30 (34.1%) died in the COVID-19 positive group ( P = 0.006). Deaths among the COVID-19 positive group had a significantly higher age than deaths in the COVID-19 negative group ( P < 0.001). Among the patients who died with positive COVID-19 status had substantially higher neutrophilia and lymphopenia ( P < 0.001). X-ray chest abnormalities were almost three times more likely in COVID-19 deaths ( P < 0.001). Conclusion: In the present article, 17.6% of SARI were due to COVID-19 infection with significantly higher mortality (34.1%) in COVID-19 positive patients with SARI. Although all patients presenting as SARI have considerable mortality rates, the COVID-19-associated SARI cases thus had an almost one-third risk of mortality.

Characterizing deaths among adult patients with severe acute respiratory infection: during the pre- and COVID-19 pandemic periods in Bangladesh, 2018–2022

“…Notably, over one-third of observed SARI deaths were linked to SARS-CoV-2 detection, underscoring the substantial mortality risk posed by the virus among SARI patients. This trend parallels findings from an Indian study involving 500 hospitalized SARI patients, indicating a higher mortality rate in COVID-19-positive SARI cases (34.1%) compared to COVID-negative instances (20.1%) [ 19 ]. Other studies also demonstrated that SARI patients had three times more risk of death due to COVID-19 during the pandemic than other respiratory viruses [ 24 , 25 ].…”

“…The pandemic revealed that SARI mortality was no longer solely attributed to influenza, but also heavily impacted by COVID-19. Countries like Brazil and India experienced a dramatic rise in SARI cases and deaths during the pandemic period [ 18 , 19 ].…”

Epidemiologic Profile of Severe Acute Respiratory Infection in Brazil During the COVID-19 Pandemic: An Epidemiological Study

“…However, the clinical presentation was similar in both groups (Pannu et al, 2021 ). Another study conducted in India (Sharma et al, 2021 ) enrolled 500 participants, in which only 88 were positive for COVID-19. Similar to the study conducted in North India, the authors observed a similar clinical profile between individuals with COVID-19 and SARI, and also, older patients were diagnosed with COVID-19 (Sharma et al, 2021 ).…”

“…Another study conducted in India (Sharma et al, 2021 ) enrolled 500 participants, in which only 88 were positive for COVID-19. Similar to the study conducted in North India, the authors observed a similar clinical profile between individuals with COVID-19 and SARI, and also, older patients were diagnosed with COVID-19 (Sharma et al, 2021 ). Finally, the most extensive study in India accounted for nearly 5,000 individuals with SARI, out of which 104 were diagnosed with COVID-19 (Gupta, N. et al, 2020 ), being the COVID-19 group had an increased number of male patients.…”

Clinical and epidemiological aspects of severe acute respiratory infection: before and during the first year of the COVID-19 pandemic in Brazil

“…Another study analysing 500 patients hospitalized due to SARI in India showed a higher mortality rate among cases associated with COVID-19 (34.1%) compared with those not associated with COVID-19 (20.6%). 17 …”